• Dolores Salas, Mercedes Vanaclocha, Josefa Ibáñez, Ana Molina-Barceló, Vicente Hernández, Joaquín Cubiella, Raquel Zubizarreta, Montserrat Andreu, Cristina Hernández, Francisco Pérez-Riquelme, José Cruzado, Fernando Carballo, Luis Bujanda, Cristina Sarasqueta, Isabel Portillo, Mariola de la Vega-Prieto, Juan Diego Morillas, Vicente Valentín, Angel Lanas, Enrique Quintero, and Antoni Castells.
• General Directorate Public Health, Avda. Calatuña, 21, 46020, Valencia, Spain, salas_dol@gva.es.
• Cancer Causes Control. 2014 Aug 1; 25 (8): 985-97.

PurposeTo compare two strategies for colorectal cancer screening: one-time colonoscopy versus fecal immunochemical testing (FIT) (and colonoscopy for positive) every 2 years, in order to determine which strategy provides the highest participation and detection rates in groups of sex and age.MethodsThis analysis was performed with data from the first screening round within the COLONPREV study, a population-based, multicenter, nationwide trial carried out in Spain. Several logistic regression models were applied to identify the influence of the screening test on participation rates and detection of proximal and distal neoplasms, as well to identify the influence of age and sex: women aged 50-59 years, women aged 60-69 years, men aged 50-59 years, and men aged 60-69 years.ResultsParticipation was higher in women than in men, especially among women aged 50-59 years (25.91 % for colonoscopy and 35.81 % for FIT). Crossover from colonoscopy to FIT was higher among women than men, especially among those aged 60-69 years (30.37 %). In general, detection of any neoplasm and advanced adenoma was higher with colonoscopy than with FIT, but no significant differences were found between the two strategies for colorectal cancer detection. Detection of advanced adenoma in both arms was lower in women [specifically in women aged 50-59 years (OR 0.31; 95 % CI 0.25-0.38) than in men aged 60-69 years]. Women aged 50-59 years in the colonoscopy arm had a higher probability of detection of advanced adenoma (OR 4.49; 95 % CI 3.18-6.35), as well as of detection of neoplasms in proximal and distal locations (proximal OR 19.34; 95 % CI 12.07-31.00; distal OR 11.04; 95 % CI 8.13-15.01) than women of the same age in the FIT arm. These differences were also observed in the remaining groups but to a lesser extent.ConclusionWomen were more likely to participate in a FIT-based strategy, especially those aged 50-59 years. The likelihood of detection of any neoplasm was higher in the colonoscopy arm for all the population groups studied, especially in women aged 50-59 years. Distinct population groups should be informed of the benefits of each screening strategy so that they may take informed decisions.

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